Related Experiment Video
Updated: Mar 2, 2026
Chronic Intermittent Ethanol Vapor Exposure Paired with Two-Bottle Choice to Model Alcohol Use Disorder
Published on: June 23, 2023
Impact of an Alcohol Withdrawal Treatment Pathway on Hospital Length of Stay: A Retrospective Observational Study
Andrew J Muzyk1, Rachel E Rogers, Gary Dighe
1MUZYK: Department of Pharmacy Practice, Campbell University College of Pharmacy and Health Sciences, Buies Creek, NC; Department of Pharmacy, Duke University Hospital, Durham, NC; and Department of Psychiatry and Behavioral Sciences, Duke University Health System, Durham, NC ROGERS: Department of Pharmacy, Duke University Hospital, Durham, NC DIGHE: Department of Pharmacy, Ohio State University-Ohio Riverside Hospital, Columbus, OH HARTUNG: Department of Pharmacy Practice, Campbell University College of Pharmacy and Health Sciences, Buies Creek, NC MUSSER: Department of Medicine, Duke University Health System, Durham, NC STILLWAGON: Department of Nursing, Duke University Health System, Durham, NC RIVELLI: Department of Psychiatry and Behavioral Sciences and Department of Medicine, Duke University Health System, Durham, NC.
Objective:
To determine if the implementation of a hospital-specific alcohol withdrawal treatment pathway used in a medical-surgical patient population decreased hospital length of stay (LOS) compared with the standard of care.
Methods:
This retrospective observational study, conducted in a large academic tertiary care hospital, involved 582 subjects who met criteria for study inclusion, with 275 subjects in the 2010 cohort and 307 in the 2012 cohort. The Alcohol Withdrawal Project Team was formed with the goal of creating a standardized approach to the recognition and treatment of alcohol withdrawal at Duke University Hospital. The group created a computerized physician order entry alcohol withdrawal treatment pathway with 4 possible treatment paths chosen on the basis of current withdrawal symptoms, vital signs, and alcohol withdrawal history. The 4 treatment paths are 1 prophylaxis; 2 mild-to-moderate withdrawal; 3 moderate-to-severe withdrawal, and 4 severe withdrawal/alcohol withdrawal delirium. Each treatment path corresponds to a different lorazepam dose and dose schedule and symptom assessment. This pathway was implemented in the hospital at the end of 2011.
Results:
Using a Cox proportional hazards model and adjusting for covariates, there was a 1 day [95% confidence interval (CI), 1-2 d] reduction in median hospital LOS between the 2010 and 2012 cohorts, 5 versus 4 days, respectively. The average ratio in hospital LOS between the 2 cohorts was 1.25 (95% CI, 1.25-1.67). The CI was estimated by bootstrapping and indicated a significantly longer LOS in the 2010 cohort compared with the 2012 cohort. Nonsignificant changes were found in the proportion of subjects admitted to the intensive care unit (24% in 2010 vs. 29.3% in 2012), LOS in the intensive care unit (7.1±8 d in 2010 vs. 5.6±6.9 d in 2012), and proportion of patients discharged with a diagnosis of delirium tremens (17.8% in 2010 vs. 15.3% in 2012).
Conclusions:
This study demonstrates the successful implementation of an alcohol withdrawal treatment pathway in a medical-surgical population hospitalized in a large tertiary care facility with significant impact on hospital LOS.
More Related Videos
09:29Investigating Drivers of Antireward in Addiction Behavior with Anatomically Specific Single-Cell Gene Expression Methods
Published on: August 4, 2022
05:40The Motivation for Alcohol Reward: Predictors of Progressive-Ratio Intravenous Alcohol Self-Administration in Humans
Published on: April 28, 2022
